Dr. Charles Jennissen, of the University of Iowa Department of Emergency Medicine presented this at CPSC's ATV Safety Summit Oct. 11, 2012. The study objective was to determine adolescent exposure to ATVs and their riding behaviors. Methods: A survey was administered to ~3,100 students, mostly 11-15 years of age, as part of an in-classroom ATV safety program. Results: Participants were distributed between urban (38%), rural (24%), and isolated rural (38%) communities. 85% reported riding an ATV at least a few times a year and 31% reported riding at least once a week. For those exposed, 92% had ridden with more than one person, 81% had been on a public road, and over 60% reported never or almost never wearing a helmet. 54% engaged in all three unsafe behaviors; 2% engaged in none. 59% had been in at least one ATV crash. Students from isolated rural communities were more likely to have ridden an ATV in the last year relative to their peers, but the likelihood of a crash was not different by rurality. Increased crash likelihood was seen for males and for youth engaged in multiple risky behaviors. Conclusions: A high percentage of youths in Iowa have been exposed to ATVs, engage in unsafe behaviors, and have experienced a crash. Significant efforts are needed to reduce ATV-related deaths and injuries in this high-risk pediatric population.